Maintaining therapeutic programmes for people with learning disabilities over long periods of time presents a major challenge to care systems as the limited and slow pace of client behavioural change is often insufficient to sustain staff behaviour. In this study, a 17-year-old young man with profound learning difficulties was successfully supported on a toilet training programme for more than 2.5 years. In spite of early setbacks and only limited behavioural change the staff team persisted with the programme. Four factors were identified as supporting staff behaviour with the programme: (1) parental involvement, (2) the therapeutic culture and values of the care system, (3) support from external agencies and (4) positive staff feelings towards the client.